The
complete resource to help parents and professionals include ALL kids in summer camp
Special
Needs Program Post-Staff Survey
Name ______
Position
Directions: Please
circle the extent to which you agree or disagree with each statement. Please add
additional comments if you have them.
SD= Strongly
Disagree; D= Disagree; U= Uncertain; A= Agree; SA= Strongly Agree
SD D U A SA
1. I think
individuals with disabilities can benefit from 1 2 3 4 5
inclusion into
camp?
I
think they can benefit in which of the following areas?
• Self-Esteem 1 2 3 4 5
• Enjoyment 1 2 3 4 5
• Social Interaction 1 2 3 4 5
• Independence 1 2 3 4 5
• Appropriate Behavior 1 2 3 4 5
• Motor Skills 1 2 3 4 5
Other
2. I
think peers without disabilities can benefit from 1 2 3 4 5
the inclusion of
children with disabilities?
I
think they can benefit in which of the following areas?
• Learning about individual differences 1 2 3 4 5
• Acceptance of others with a disability 1 2 3 4 5
• Self-Esteem 1 2 3 4 5
• How to interact with someone with a
disability 1 2 3 4 5
Other
3. I
feel that peers without disabilities will socialize with 1 2 3 4 5
individuals with
disabilities free of adult intervention?
Directions: Please
circle the extent to which you agree or disagree with each statement. Please add
additional comments if you have them.
SD= Strongly Disagree;
D= Disagree; U= Uncertain; A= Agree; SA= Strongly Agree
SD D U A SA
4. I
feel that peers without disabilities will be:
• Friends 1 2 3 4 5
(people with whom the individual has a
mutual, and
reciprocal relationship spending time and sharing experiences
during camp)
• Acquaintances 1 2 3 4 5
(Person who has a brief impersonal interactions by
planned or chance encounters during
camp)
• Service Provider 1 2 3 4 5
(People for whom the relationship is
based on an obligation
to provide interaction and services
with individuals with disabilities?
5. I
think inclusion might interfere with activities 1 2 3 4 5
at Camp?
Explain:
6. I
have fears and concerns about the inclusion
of 1 2 3 4 5
individuals with
disabilities at the Camp.
Explain:
7. At
this time, which statement would most accurately reflect your outlook regarding
inclusion at the Center? (Please check
one)
_____ I
still have many reservations about how inclusion will work.
_____ I
am still mildly concerned about how inclusion will work.
_____ I
am still not sure how inclusion will work.
_____ I
look forward to the inclusion of individuals with disabilities and helping to
make it work.
_____ I
am excited about inclusion and feel everyone will benefit from the experience.
8. What did you learn from the inclusion of
individuals with disabilities?
9.
Over the course of the summer, do you feel that campers in your group demonstrated
some increased acceptance of having a camper with a disability? YES______ NO______
If possible, please give an example:
10.
Additional Comments:
THANK YOU
Brad Gilbertson, Special Needs Director
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